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Executive Summary 
With the ravages caused by emerging and re-emerging morbidities and infections such as HIV and AIDS, 
hepatitis B and C, respectively, among others, proper management of health care waste is increasingly 
assuming a critical role in efforts to control health risks associated with exposure to improperly managed 
health care waste. The Ministry of Health (MoH) in collaboration with the National AIDS Control Council 
(NACC), World Bank, World Health organization (WHO), Centre for Disease Control (CDC) and John Snow 
Inc (JSI) Infection Safety Project plans to provide a new impetus through supporting the development of a 
National Health Care Waste Management Plan for the period 2006-2015 for Kenya.  As a first step in setting 
the framework for the development of the Plan of Action on Health Care Waste Management (HCWM), a 
study aimed at determining and assessing the prevailing situation of health care waste management at all 
levels of health institutions was conducted. 
 
The broad objective of the study was to undertake a situational analysis of health care waste management 
through assessment of policy, legal and administrative framework in relation to Health Care Waste 
Management (HCWM); including generation, segregation, storage and disposal systems of Health Care 
Waste (HCW), what is generally referred to as 
“cradle to grave”
 of health care waste management. The 
study also assessed the existing technologies, levels and presence of scavenging and recycling; 
established the cost benefits of public
–private partnership in health care waste management and finally 
reviewed existing training curricula, identifying unmet needs and proposing appropriate and affordable 
strategies for the training at various levels.  
 
Rapid Assessment Appraisal tools, including structured and semi-structured questionnaires, check lists and 
guides for participatory appraisal, among others were employed in the data collection. A sample of health 
care institutions ranging from those at the national, provincial, district, health centre and dispensary levels 
were picked randomly to cover all the 8 administrative provinces of Kenya.   
 
The study findings indicate that to a given extent there has been some positive effort in the management of 
HCW in Kenya that is worth mentioning and upon which the need to develop the Plan of Action for the 
management of HCW has been built.  Specifically, the Ministry of Health in spite of the fact that it does not 
have adequate resources for Health Care Waste Management, it does have in almost all the HCFs the 
Public Health Technicians (PHTs) and Public Health Officers (PHOs), whom the study found out are well 
trained in handling HCWs and are responsible for the management of HCW generated in these HCFs. 
These officers have been discharging their duties in respect to HCWM inspite of several challenges and 
constraints. Most HCFs have also employed casuals and subordinate staff who play a major role in the 
collection and disposal of HCWs although they have received no or inadequate training in HCWM.  
 
The key findings at different points of HCWM were as summarised here below: 
 
At the health care facilities, inadequate or lack of segregation of waste, there were lack of HCWM Strategy, 
inadequate HCW receptacles, inappropriate internal HCW storage facilities, inappropriate internal transport 
facilities, delay in HCW collection, lack of budgetary allocations for HCW, tedious procurement approval 
process, lack of Personal Protective Gears/PPE, lack of pre-treatment of HCW before final disposal, and 
lack of waste minimisation strategy. However in all HCFs sampled, the waste that is properly segregated are 
sharps, which are placed in sharp boxes.  
 
At the HCW treatment plants, most of the HCFs have broken /dilapidated “incinerators”, there is lack of back 
up incinerators in cases of failure, broken down Auto Clave equipments, small capacity of incinerator and 
low incinerator stacks. 
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